How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $1.05 | Facility | None | $0.40 | $0.40 | $1.05 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.71 | Professional | None | $0.40 | $0.40 | $0.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $1.51 | Professional | None | $0.40 | $0.40 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $0.44 Median $0.56 Typical High $0.62 | Facility | None | $0.44 | $0.56 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Emblem Health Setting Facility Modifier None Typical Low $0.38 Median $0.48 Typical High $0.89 | Facility | None | $0.38 | $0.48 | $0.89 |
Emblem Health Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | None | $0.44 | $0.44 | $0.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.45 | Facility | None | $0.43 | $0.43 | $0.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.45 | Professional | None | $0.43 | $0.43 | $0.45 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.46 Median $0.76 Typical High $1.45 | Facility | None | $0.46 | $0.76 | $1.45 |
Highmark BCBS Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
MVP Health Care Setting Facility Modifier None Typical Low $0.52 Median $0.62 Typical High $2.95 | Facility | None | $0.52 | $0.62 | $2.95 |
MVP Health Care Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.83 | Professional | None | $0.56 | $0.56 | $0.83 |
United Setting Professional Modifier None Typical Low $0.43 Median $0.46 Typical High $0.68 | Professional | None | $0.43 | $0.46 | $0.68 |
Univera Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.52 | Facility | None | $0.43 | $0.43 | $0.52 |
Univera Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.87 | Professional | None | $0.43 | $0.43 | $0.87 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where New York sits
The same service costs 4.0 times more in Texas than in Georgia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 37th of 51
$0.43
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.